中部某醫學中心提升住院藥品退藥效率之研究

目的：住院病人因故未使用藥物，導致已配出藥物又退回藥局；每日被退回的藥物品項與數量之多，常使得藥師需花費相當多時間來處理退藥，間接地擠掉進行其他藥事照護服務的人力與時間。為提升退藥效率，我們以精實思維，利用品管圈手法，進行此作業流程改善。方法：為瞭解現況，首先對內部顧客進行開放式問卷調查，運用親和圖法找出問題點及藥師需求。重新檢視現有的調劑流程，參考其他醫院及文獻後設計理想的作業流程，並訂出改善項目、改善方法及步驟。結果：經過改善後，整體而言退藥時間平均減少31.7%，首劑不合理率減少37.8%，退藥正確性平均提升41.1%，藥師滿意度也提高。最後，我們將新的作業方法寫入藥學部標準程序作業書以確保成果能夠持續維持。結論：透過精實專案的進行，提升退藥作業效率﹔並將節省出來的時間重新分配運用至照護病人，進而提升病人用藥安全與醫療照護品質。

關鍵字

病人安全；住院藥局；精實思維；品管圈；退藥

並列摘要

Objective: We aim to improve the efficiency of returning medicine to pharmacies. Returning medicine is necessary work, but it consumes significant amounts of time and resources. For that reason, the development of a new service was restricted. We expected that a new process can improve work efficiency. Methods: This study was driven by the quality control circle (QCC) technique and lean thinking. First, we surveyed the needs of pharmacists by questionnaire and identified values. Through the lean principle, we drew the current value stream and future value stream. A management information system was used to support our strategies. Results: After implementation of the strategies, the working time of returning medicine was reduced by 31.7%, and the quantity of unnecessary first dose prescriptions decreased by 37.8%. In addition, the correctness of returned medicine is improved, as is the pharmacist satisfaction of returning medicine. Conclusions: The efficiency of returning medicine was improved after this study was implemented; furthermore, more pharmacists were involved in clinical pharmaceutical care to improve medication safety.

並列關鍵字

Patient Safety ； Inpatient Pharmacy ； Lean Thinking ； Quality Control Circle ； Returning Medicine

國際替代計量

中部某醫學中心提升住院藥品退藥效率之研究

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